USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1941 > Part 29
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FATHER (City)
(State or country)
Maine
15 MAIDEN NAME
OF MOTHER
Eliza Dyer
16 BIRTHPLACE OF
Addison
MOTHER (City).
(State or country)
Maine
Relation, if any
Sister
V
(Address) 17 Pauline St. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued :
(Signature of Agent of Board of Health or other) health Officer 5/17/4/
(Official Designationg (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
may
(Month)
(Day)
(Year)
19
I HEREBY CERTIFY,
That I attended deceased from
March 31, 1941, to Irecay 15
....
19 .......
Duration IMPORTANT I last saw HER alive on may 15 19.4, death is said to have occurred on the date stated above, at fremme@ 6:30 in Immediate cause of death HEmmolage
Due to.
Capannone f, Lwer
Due to.
Other conditions.
(Include pregnancy within 3 months of death)
IMPORTANT
PHYSICIAN
Major findings:
Of operations.
Carmona of Lever
Underline the cause to
Of autopsy.
Date of mandagmy which death should be charged sta- tistically.
20 Was disease or injury in any way related to occupation of deceased ?.
If so, specify ...
Salvatore Capraro
M. D.
(Address)
193 Hammer SH Boeken Date many 161941
21 .. Forest ..... Hills ..
Boston
Place of Buriel, Cremation or Removet.
Ï8
1941
(City or Town)
DATE OF BURIAL
May
22 NAME OF
FUNERAL DIRECTOR
Howard S Pumoldo
ADDRESS
Winthrop mass
Received and filed MAY 2 8 1941
19
(Registrar)
....
(If U. S.
War Veteran,
specify WAR)
(a) Residence. No ..
....
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
16
6 Age of husband or wife if alive. 65
Bath
What test confirmed diagnosis ?.
(Signed)
Bath
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS
GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased. bis supposed age, the disease of which he died, definded as required by section one, where same was contracted. the duration of his last illness, when last seen alive by the physician or officer and the date of bis deatb . . . Gen. Laws, Chap. 46, Sec. 9.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body wbich has not been buried, until he has received a permit front the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one ce:netery to another. or from one grave or tomb other than the receiv- ing tomb to another in the same cemetery, until he has received a permit from the board of bealth or its agent aforesaid or from the clerk of the town where the body is buried. No such permit sball be issued until tbere shall bave been delivered to sucb board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of tbe attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is in- sufficient, a physician who is a member of the board of health, or em- ployed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, tbe medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one towu to another witbin the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body sball be returned to the town from which it was removed within thirty-six bours after such removal, unless a permit in the usual form for the re- moval of such body has been sooner obtained hereunder. if the death certificate contains a recital, as required by section ten of chapter forty- six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, sucb recital shall appear upon tbe permit. The board of bealth, or its agent, upon receipt of sucb statement and certificate, shall fortbwith countersign it and transinit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death sball thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the deatb, which the clerk or registrar may require .- Chop. 114, Sec. 45, G. L., (Tercentenary Edition).
No undertaker or other person shall bury a human body or the ashes thereof which bave been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue sucb permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held. or froin a person appointed to have the care of the cemetery or burial ground in which the interment is made. . .. Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of tbe following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septiceinia). and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deatbs from disease resulting from injury or infection related to occupation, tbe sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name tbe disease causing deatb. As related causes, name earlier morbid conditions, if any. related to the principal cause and any important complication of tbe principal cause.
Statement of Occupation .- Precise statement of occupation Is very important, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or cbanged on account of tbe disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who bad no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
M R-301 A
PLACE OF DEATH
Suffolk (County)
Winthrop
(City or Town)
No 61 Washington Avenue
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No
§ (If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number)
2 FULL NAME
Ellen Lydia Howe
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(If U. S.
War Veteran,
specify WAR)
(a) Residence. No.
61 Washington Avenue
St
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
years
months
days.
In this community
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Singl
5a If married, widowed, or divorced HUSBAND of.
(Give malden name of wife in full)
(or) WIFE of ...
(Husband's name in full)
6 Age of husband or wife if alive ..
years
7 IF STILLBORN, enter that fact here.
8
91 Years
5
Months ..
21 Days
If less than 1 day .Hours Minutes
Usual
9 Occupation :
At home
10 or Business:
11 Social Security No ...
Milford
12 BIRTHPLACE (City).Massachusetts (State or country)
13 NAME OFGeorge W. Howe FATHER
14 BIRTHPLACE OF
FATHER (City)
Upton
(State or country)
Massachusetts
15 MAIDEN NAME
OF MOTHER
Betsey Corbett Perry
16 BIRTHPLACE OF
MOTHER (City)
Milford
(State or country)
Massachusetts
17 Relation, if any
Info Betsey Lindsay Lane niece ....... ) (Address) 61 Washington Ave Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of Health of other)
5/19/4/ (Date of Issue of Permit, /
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
may
17
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY.
That I attended deceased from
October 2
19.40, to May 17 1941 I last saw her alive on mars 16 ., 194/, death is said to have occurred on the date stated above, at 6:35 A .. m. Immediate cause of death.
Duration IMPORTANT
Bronchopneumonia, terminal
Due to. Cerebral hemorrhage
2 woke
....
years 1
Other conditions.
(Include pregnancy within 3 months of death)
Carcinoma of breast
IMPORTANT
PHYSICIAN
Major findings: Of operations Lvone
Date of
Of autopsy.
22
one
What test confirmed diagnosis ?. clinica
20 Was disease or injury in any way related to occupation of deceased?
If so, specify .. ) ..... 4 ...
(Signed).
(Address) Menthe Mass Date May 18 1941.
M. D.
21 Pine Grove Cemetery Milford Mass Place of Burial, Cremation or Removal. (City or Town)
DATE OF BURIAL.
May 20 1941
19
22 NAME OF
FUNERAL DIRECTOR
Charles R . Bennison
ADDRESS
Winthrop Mass
Received and filed MAY -2-8 -.... 1941. 19
(Registrar)
1 3 SEX Female AGE PARENTS is very important. See instructions and extracts from the laws on back of certificate. CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state Industry
100m-2-'40-D-729-a
(Official Designation)
Underline the cause to which death should be charged sta- tistically.
Due to. Generalized arterio-sclerosis
1941
(If nonresident, give city or town and state)
22 yrs.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he bas attended during his last illness, at the request of an undertaker or other authorized person or of any member of tbe family of the deceased, furnisb for registration a standard certificate of death, stating to the best of his knowledge and belief tbe name of tbe deceased, liis supposed age, the disease of which he died, defined as required by section one, wbere same was contracted, the duration of his last illness, wben last seen alive by tbe physician or officer and the date of bis deatb .. . Gen. Laws, Chap. 46, Sec. 9.
No undertaker or other person shall bury or otherwise dispose of a buman body in a town, or remove tberefrom a human body wliich has not been buried, until he has received a permit from the board of health. or its agent appointed to issue such permits, or if there is no such board, from tbe clerk of the town wbere the person died; and no undertaker or otber person sball exhume a buman body and remove it from a town, from one cemetery to another, or from one grave or tomb other than tbe receiv- ing tomb to another in the same cemetery, until he has received a permit from the board of bealth or its agent aforesaid or from the clerk of tbe town where the body is buried. No such permit sball be issued until tbere shall have been delivered to such board, agent or clerk, as tbe case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law. or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if. for sufficient reasons, bis certificate cannot be obtained early enough for the purpose, or is in- sufficient, a physician who is a member of the board of bealth, or em- ployed by it or by the selectmen for the purpose, shall upon application make the certificate required of tbe attending physician. If death is caused by violence, the medical examiner shall make sucb certificate. If sucb a permit for the removal of a buman body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that sucb body shall be returned to the town froin which it was removed within tbirty-six hours after such removal, unless a permit in the usual form for the re- moval of such body has been sooner obtained bereunder. If the death certificate contains a recital, as required by section ten of chapter forty- six, that the deceased served in the army, navy or marine corps of the United States in any war in which it bas been engaged, such recital shall appear upon the permit. Tbe board of bealth, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to tbe clerk of the town for registration. The person to whom the permit is so given and the physician certifying tbe cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which tbe clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
No undertaker or other person shall bury a human body or the ashes thereof which bave been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have tbe care of the cemetery or burial ground in which the interment is made. . . . Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of tbe following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to wbom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from bome when the certificate of deatb is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not tbe mode of dying, e. g., beart failure, asphyxia, astbenia, etc. As principal cause name tbe disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of tbe principal cause.
Statement of Occupation .- Precise statement of occupation is very important, so that the relative bealthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing deatb, report tbe usual occupation prior to illness. If tbe deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman wbose only occupation was that of home bousework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who bad no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
M R-301 AJ
PLACE OF DEATH
(County)
(esty or ffown)
No ... anthrop Command
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
8.3
Registered No. (If death occurred in a hospital or institution, give its NAME instead of street and number)
(If U. S. War Veteran, specify WAR) fast Boot
(If nonresident, give city or town and state)
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
1 SEX Female White
1 5 SINGLE
MARRIED
WIDOWED
(writethe word)
Manuel
Sa If married, widowed, or divorced HUSBAND of
(Husband's name in full)
55
.years
7 IF STILLBORN, enter that fact here.
8 49 Years
If less than 1 day
Months Dayş
Hours
Minutez
Housewife
Industry
At Home
11 Social Security No. Province of Semana
12 BIRTHPLACE (City)
(State or country)
Ceaser Dovoni
Grovemed
14 BIRTHPLACE OF
FATHER (City)
(State or country)
15 MAIDEN NAME
OF MOTHEP
Angela Giliberti
16 BIRTHPLACE OF
MOTHER (City)
Province of severe
(State or country)
17 Celso Parecchio C
Rotation, if any
Informant (Address) 152 Jeden Wo, back Color
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burigy or transit permit was issued: Ww D. Children (Signature of /Agent of Board of Health or other) Health Office (Oficial Designation
5/23/41 (Date of Issue of Permit
18 DATE OF
DEATH.
may
19
1941
(Month)
(Year)
(Day)
That I attended deceased from
19
I HEREBY CERTIFY.
6/25
19.5.0.,
119
19.8 /
I last saw h &malive on ...... 19 ... 1., death is said to have occurred on the date stated above, at 9,10A .. m.
Immediate cause of death.
Duration IMPORTANT
2 days
Due to
Carmona of transne
cream
Due to
Other conditions
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Elevation Jedin
PHYSICIAN Underline the cause to ¡which death of 3/25/41 Of autopsy should be charged sta- What test confirmed diagnosis ?
20 Was disoase cr Injury in any way related to occupation of deceased?
If so, specify.
Frank Fhandle
(Signed).
. I.I. D.
(Address).
Data 5/2/ 194/ 21 St Minute Cemetery Bastão. Place of Burial, Cremationoy Removal (City or Town) DATE OF BURIAL .. May 23, 41
22 NAME OF FUNERAL DIRECTOR ADDRESS 978 function No . Cont ables
Received and Sled. MAY 2 8 1941
19
(Registrar)
2 FULL NAME
Romilde (Nebovoni) Vareschi
(If deceased is a married, widowed or divorced woman, give also maiden name.) 152 Jegdin
St.
(a) Residence. No ... (Usual place of abode) Length of stay : In hospital or institutions ...
Hospital
(Specify whether)
years
months 3
days.
MEDICAL CERTIFICATE OF DEATH
COLAR OR RACE
6 Age of husband or wife if alive.
or DIVORCED
Mochilas
1 (or) WIFE of AGE Usual 9 Occupation: 10 or Business: PARENTS Birthplace Trovino y Ferrara is very important. See instructions and extracts from the laws on back of certificato. CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state 100m-10-'39. No. 8427- I. D .- WNIE FLAINE, WITH CIALIS PLAVA LA TO DO A IEMMANCAI RECORD. Every item of 13 NAME OF FATHER
tistically.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for regis- tration a standard certificate of death, stating to the best of bis knowledge and belief the name of the deceased, bis supposed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of bis dcatb ... Gen. Laws, Chap. 46, Sec. 9.
No undertaker or other person sball bury or otherwise dispose of a human body in a town, or remove therefrom a human body which bas not been buried, until he has received a permit from the board of bealth, or its agent appointed to issuc such permits, or if there is no such board, from the clerk of the town where the person died ; and no undertaker or other person sball exbume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than tbc receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been de- livered to such board, agent or clerk, as the case may bc, a satisfac- tory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the pur- pose, shall upon application make the certificate required of the at- tending physician. If death is caused by violence, the medical exam- iner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another witbin the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in tbe possession of the undertaker desiring to make such removal shall constitute a permit for such removal ; provided, tbat such body shall be returned to the town from which it was removed witbin thirty- six bours after such removal, unless a permit in the usual form for tbe removal of such body bas been sooner obtained hereunder. If the death certificate contains a recital, as required by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital sball appear upon the permit. The hoard of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter fur- nisb for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the deatb, which the clerk or registrar may require .- Chap. 114, Scc. 45, G. L., (Tercentenary Edition.)
No undertaker or other person shall bury a buman body or the asbes thereof which have been brought Into the commonwealth until he has received a permit so to do from the board of health or Its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burlal ground in which the interment is made. ... Chap. 114, Sec. 46, G. L., (Tercentenary Edition)
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